Thromboelastography with platelet mapping to guide anesthetic management of emergency cesarean delivery in a patient with thrombasthenia: a case report

JA Clinical Reports

Case Report

Yoshiki Nakajima¹  Yuji Suzuki¹  Shingo Kawashima¹  Chieko Akinaga¹  Masako Matsumoto² 

[1] Department of Anesthesiology and Intensive Care Medicine, Hamamatsu University Hospital, 1-20-1 Handayama, Higashi-Ku, Hamamatsu-Shi, 431-3192, Shizuoka, Japan;Department of Obstetrics and Gynecology, Hamamatsu University Hospital, Hamamatsu, Japan;

关键词: Thrombasthenia;    Thromboelastography;    Platelet function tests;    Pregnancy;    Cesarean section;    Spinal anesthesia;   

DOI  :  10.1186/s40981-023-00623-x

 received in 2023-02-20, accepted in 2023-05-16,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundPerinatal management of congenital platelet dysfunction represents a challenge. One of the major concerns is whether neuraxial anesthesia can be applicable for cesarean delivery. We present a patient with thrombasthenia who underwent emergency cesarean delivery.Case presentationA 34-year-old primipara was diagnosed with autosomal dominant thrombasthenia, which was not classified as any known type. A thorough examination revealed that adenosine diphosphate aggregation and collagen aggregation were suppressed. Platelet mapping of viscoelastic testing was used to observe the trajectory of platelet function during pregnancy, which was found to be normal to hypercoagulable until 38 weeks of gestation. On the basis of the results of testing and physiological status, we commenced spinal anesthesia and avoided prophylactic platelet transfusion.ConclusionThe platelet mapping of viscoelastic testing was rapid and simple, allowing repeated examinations. We could choose the appropriate anesthesia method and determine the necessity of blood transfusion for a pregnant patient with thrombasthenia.

【 授权许可】

CC BY   
© The Author(s) 2023